Poverty's Youngest Victims: Ethical Choices for First Responders and Advocates in the Fight for Healthy and Affordable Food

Opening with an excerpt from Hungry in America, a documentary slated to open this winter, “Poverty’s Youngest Victims: Ethical Choices for First Responders and Advocates in the Fight for Healthy and Affordable Food” centered on issues of food security and approaches to partnerships between medical and legal professionals.

Dr. Mariana Chilton, associate professor at the Drexel University School of Public Health, provided a brief explanation of the Witnesses to Hunger photo advocacy project, which equipped 42 Philadelphia women with cameras so they could document the process of raising children in poverty.

Chilton said she was inspired to launch Witnesses to Hunger after being called to testify before Congress on the impact of public policy with regard to the health of young children. Disappointed in the House of Representatives’ response to her testimony and “total lack of understanding” of the realities of poverty, Chilton found it “unacceptable that [she] would be there as an ‘expert witness’ when there’s someone who’s homeless and hungry and completely disregarded in the national dialogue.”

Chilton, who also serves as principal investigator for the Philadelphia Grow Project and co-principal investigator of Children’s Health Watch, stressed that Witnesses to Hunger—which has since produced 10,000 photographs exhibited nationwide—is not about “voyeurism,” but social action.

The principal objective of the project, Chilton said, is one of “[cutting] through indifference and [bringing] to light the experience of hunger that is generally muffled and hidden by those who experience it.”

To shed light on the magnitude of hunger in the United States, she cited statistics indicating approximately 49 million people—14 percent of the general population—are food insecure and, as such, lack access to enough food to maintain an active and healthy lifestyle.

University of Maryland School of Law Professor David Super voiced “emphatic agreement” with Chilton’s view of hunger as a “problem that defies isolation.”

Due to the recent economic crisis, Super said, state governments are largely understaffed and undergoing attrition at a time when the number of applicants for assistance has been rising.

“Tens of thousands of households that remain eligible for assistance are being arbitrarily cut off because the state doesn’t have the staff to handle the paperwork that keeps them in [the food stamp program],” he said, adding that the most vulnerable sector of the population is the “new poor”—that is, aid applicants who had not required assistance before the economic downturn and are consequently unfamiliar with the availability of legal services and welfare programs.

Because many of those in need do not seek out legal aid on their own, Super advised public advocacy lawyers to locate clients by “working closely with healthcare providers.”

According to Dr. Kathleen Conroy, Medical Director at Medical-Legal Partnership and Children’s Hospital Boston pediatrician, “medicine…is really the tip of the iceberg” given the fact that low-income families are often facing a variety of poverty-related stressors.

She then presented the findings from a 2007 study indicating that while patients are willing to discuss food insecurity with their physicians, healthcare providers consistently fail to inquire into this area of their patients’ lives.

“As a medical person it’s shocking to realize the legal services available to low-income people are so few,” Conroy said, characterizing legal needs as a subset of social needs requiring legal intervention. “Medical staff can help fill the information gap.”

Jonathan Stein L’67, General Counsel at Community Legal Services, speculated that much of the “nonasking” Conroy describes is grounded in “doctors thinking they can’t do anything” and can be remedied by empowering medical personnel to expand the range of assistance they provide to patients.

“Poverty requires a broad attack on many fronts,” he said, urging law students interested in public advocacy to participate in pro bono work and seek externships with nonprofits.

“The critical component of any profession is having a vision of systemic reform,” Stein said. “[Law students] can [use] their individual casework experience to [see] broader problems that need impacting.”